APPENDIX: INDIVIDUAL APPLICATION BELL COUNTY BAIL BOND BOARD BELTON, TEXAS Approved as of June 16, 2011

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1 APPENDIX: INDIVIDUAL APPLICATION BELL COUNTY BAIL BOND BOARD BELTON, TEXAS Approved as of June 16, 2011 IN ACCORDANCE with the requirements of Section 1704 Texas Occupation code, as, Amended, the undersigned makes application for license to act as a bondsman in Bell County, Texas, as required by said statue, the following is submitted in support of said application: Applicant applies for: ( ) Original Application ( ) Renewal Application 1. Name of applicant: Date of Birth: Social Security Number: Driver's License Number: Bell County business address: Bell County business telephone: Home address: Home telephone: 2. Are you a citizen of the United States? Are you a resident of the State of Texas? 3. (a) State when and for whom you have had at least one year of continuous work experience in the bail bond business in the two years preceding this application. 1

2 (b) State the dates and institution(s) of higher education where within the two years preceding this application you have completed at least eight hours of continuing legal education in criminal law courses or bail bond laws courses, approved by the State Bar of Texas. Attach a copy of any certificate evidencing the completion of such courses. 4. (a) The application shall be accompanied by letters of recommendation from three reputable persons, other than attorneys, or employees of law firms, who have known the applicant for a period of at least three years. Each letter shall recommend the applicant as having a reputation of honesty, truthfulness, fair dealing, and competency and shall recommend that the license be granted. (b) Applicant is licensed in the following counties (list counties): 5. (a) The application shall be accompanied by the fee required by law. (b) A photograph of applicant shall be attached to the application. (c) A set of fingerprints of the applicant shall be attached to the application. 6. (a) Please furnish answers to the following additional questions: (1) How long have you been engaged in the bonding business? (2) Have you or any of your employees or agents ever been convicted of felony offense, or of a misdemeanor offense involving moral turpitude in any Court in this State or any other State or of the United States? (Check one) Yes No (If yes, give date, name of persons convicted, offense, place (city and state) and disposition (penalty assessed). 2

3 (b) On how many bail bonds written in Bell County, Texas do you appear as surety at this time? (attach hereto a list of all outstanding bonds on which the applicant is now a surety. In this regard, please show the County, Defendant's name, date of bond and amount of bond). (c) What is the total amount of such bonds requested in question 6-b above? $ (d) Do you have any unpaid final judgments pending against you as surety on a bailbond or bonds at this time? (Check one) Yes No If yes, give the following information on each: County Cause No. Defendant's Name Date Amt of Judgment Add additional sheets if necessary. (e) Individual applicant states that as of the date of this application, applicant has no unpaid final judgments of forfeiture against applicant in any county in which applicant holds or has held a license. 7. If a partnership, following is the name and address of each partner. 8. By signing this application, applicant states that applicant will immediately advise the Bell County Bailbond Board in writing of any bonds applicant executes in Bell County for persons charged in another county. 9. (a) The business will be conducted under the following name: (b) State the name of the person to be in charge of applicant's business at each business address if a person other than the applicant: Name Address Name Address Name Address 3

4 10. State the name, address, and city in Bell County, Texas, of each place where the business will be conducted 11. List any non-exempt real estate owned by the applicant that the applicant intends to convey in trust to the Board to secure payment of any obligations incurred by the applicant in the bonding business if the license is granted. The value of all such property must be at least $50, The following shall be included for each parcel listed: (a) A legal description equivalent to the description required to convey the property by general warranty deed. (b) Current statements from each taxing unit with power to assess or collect taxes against the property indicating that there are no outstanding tax liens against the property and indicating the net value of the property according to a current appraisal made by a real estate appraiser who is a member in good standing of a nationally recognized professional appraiser society or trade organization that has an established code of ethics, educational program, and professional certification program. (c) While the property remains in trust, the applicant: (1) Agrees to pay the taxes on the property; (2) Will not further encumber the property without notifying and obtaining the permission of the Board permitting the encumbrance, (3) Agrees to insure and keep current the insurance on any improvements on the property against any damage or destruction while the property remains in trust, in the full amount of the value claimed for the improvements. (4) A statement indicating whether the applicant is married and, if so, a sworn statement from the spouse agreeing to transfer to the Board, as a part of the trust, any right, title, or interest that the spouse may have in the property. (d) The spouse must execute the deed of trust to any community property placed in the security conveyed to the Board. 4

5 12. State the amount of cash or cash value of any certificate of deposit or cashier's check which the applicant intends to place on deposit with the County Treasurer to secure payment of any obligations incurred by the applicant in the bonding business if the license is granted. Complete and swear to a financial statement in the form attached to this application form Applicant certifies that he (has) (has not) been denied or refused a license to act as bondsman in the courts of Texas during the past 12 months. 15. How many bond forfeiture proceedings are pending against you at this time? (Give the following information for each) County Cause No. Defendant's Name Date Amt of Bond Add additional sheets if necessary. 16. Are you involved in any civil litigation (other than bond forfeiture proceedings hereinbefore stated) at this time? (Check one) Yes No. If yes, give the date of filing of such suit, names of the parties, court in which pending and brief description of nature of the litigation? 17. 5

6 By signing this application, applicant declares that applicant will comply with the Bailbond Act, Section 1704 Texas Occupation Code, as amended and with the rules and regulations of the Bell County Bailbond Board as amended. 18. Applicant makes each of the foregoing statements, together with each statement in each enclosure hereto, for the purpose of inducing the Bell County Bailbond Board, Bell County, Texas, to issue to applicant a license to act as bondsman in the courts of Bell County, Texas, well knowing and understanding that any representation herein and therein which is not true and correct, or any misrepresentation or omission which causes the same not to truly and accurately demonstrate his personal and financial responsibility as a licensed bondsman in said Courts, may result in the denial of said license, the denial of any renewal thereof, or in the revocation thereof should the same be granted under this application. DONE this the day of, A.D. 20. STATE OF TEXAS COUNTY OF BELL Applicant BEFORE ME, the undersigned authority, a Notary Public in and for Bell County, Texas, on this the day of personally appeared, known to me to be the person whose name is subscribed to the foregoing instrument, who having been by me duly sworn, deposes and says that he signed the same in the capacity therein expressed, for the purposes and considerations therein expressed, and, further, that to his actual knowledge every statement contained therein, together with all enclosures thereto, are true and correct. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of, A.D. 20. Notary Public In and For State of Texas 6

7 LIST OF ENCLOSURES This application must be accompanied by the following documents and is considered incomplete until the same having been supplied by the applicant. An incomplete application will not be considered by the Board. (a) If the business is operating under an assumed name, attach a current copy of such assumed name certified to by the County Clerk of Bell County, Texas. (b) A list of all non-exempt property owned by the applicant that the applicant intends to convey in trust to the Board to secure payment of any obligations incurred by the applicant in the bonding business. (c) If real property is to be conveyed to the Board as security, a copy of the deed and: 1. Current statements from each taxing unit wherein the property lies. 2. Agreement to keep all taxes paid while the property remains in trust. 3. Appraisal. 4. Statement not to encumber the property. 5. Agreement to keep improvements on the property insured. 6. A statement indicating whether the applicant is married. 7 A statement indicating whether the property is community property. 8. A sworn statement from the spouse agreeing to transfer the property to the Board. (d) A fully completed and sworn financial statement in the form attached shall be submitted with the application. (e) Three letters of recommendation for the applicant. (f) A photograph of applicant. (g) A set of fingerprints of the applicant shall be attached to the application. (h) A copy of the receipt showing that the filing fee has been paid to the Treasurer of Bell County, Texas. (i) A statement of the cash value of any certificate of deposit, etc., to be posted as security or the certificate itself. (j) An affidavit designating what property applicant claims as homestead and a sworn statement agreeing to immediately notifying the Board of any change in homestead designation. (k) A sworn statement that as of the date of the application, the applicant has no unpaid final judgments of bond forfeiture against applicant in any county in which the applicant holds or has held a license. (l) Copies of certificates of completion of continuing legal education courses, if applicable. 7

8 APPENDIX 8 TO: THE BELL COUNTY, TEXAS BAIL BOND BOARD PERSONAL FINANCIAL STATEMENT OF AS OF, 20 Submitted to the Bail Bond Board as part of an application to write Bail Bonds as required by the rules and regulations of the board. SECTION 1: INDIVIDUAL INFORMATION Name: Residence Address: City, State, Zip: Position or Occupation: Business Name: Business Address: City, State, Zip: Residence Phone: Social Security Number: Drivers License Number: Attach extra pages if needed to complete any section Business Phone: Date of Birth: State: SECTION 2: BALANCE SHEET ASSETS (Omit Cents) LIABILITIES (Omit Cents) Cash (Schedule 1) Secured Marketable Notes Payable to Banks (Schedule 4) Unsecured Securities (Section 2) Nonmarketable Other Accounts and Notes Payable To Relatives Notes and Accounts Receivable (Schedule 4) To Others Professional Accounts Receivable Outstanding Credit Card Balances Wholly-owned Wholly-Owned Real Estate (Schedule 3) Homestead Owing on Real Estate (Schedule 3) Homestead Partial Interest Partial Interest Cash Surrender Value of Life Insurance (Section 4) Income Taxes Year: Make: Value: Taxes Owing Other Taxes Autos: Year: Make: Value: Year: Make: Value: Oil Interest/Production Leases Personal Property - Household, Etc. Other Liabilities (Itemize) Other Assets (Itemize) ECTION 3: CONTINGENT LIABILITIES As Endorser As Guarantor On Leases or Contracts Legal Claims or Judgements Provision for Federal Income Tax Total Liabilities Net Worth Total Assets $ Total Liabilities and Net Worth $ Other (Itemize) Have you ever made a composition settlement or taken bankruptcy? If yes, Explain: ECTION 4: LIFE INSURANCE AND ANNUITIES (Including employer provided) COMPANY FACE AMOUNT BENEFICIARY CASH VALUE POLICY LOAN NET CASH VALUE INSURED PLEDGED? YES or NO TOTAL $

9 SECTION 5: SCHEDULES 9 NUMBER 1: CASH IN BANKS AND OTHER INSTITUTIONS NAME AND LOCATION TYPE OF ACCOUNT BALANCE ($) UMBER 2a: SECURITIES-MARKETABLE i.e. GOVERNMENT ISSUES, LISTED SECURITIES Face Value of Bond or No. of Stock Shares Description of Security Stock Exchange Total Cost Present Market Value Income Received Last Year TOTAL $ Registered To Whom If Pledged, To Whom TOTAL $ UMBER 2b: SECURITIES-NONMARKETABLE i.e. CLOSELY HELD FIRMS Face Value of Bond or No. of Stock Shares Description of Security Total Cost Present Market Value Income Received Last Year Registered To Whom If Pledged, To Whom UMBER 3: REAL ESTATE. The legal and equitable title to all real estate listed in this statement is solely in the name of the undersigned, unless noted: Description or Street Number Date Acquired (MM/DD/YY) Improvements Consist of Mortgage or Lien Holder Purchase Price Current Debt Outstanding Present Market Value UMBER 4: NOTES PAYABLE: Holder s Name and Location Original Commitment Amount Date Opened (MM/DD/YY) Current Balance Maturity Date (MM/DD/YY) Collateral do hereby acknowledge that this personal financial statement is being prepared for the purpose of submitting to the Bell County Bail Bond oard an application for the renewal of a license to write bail bonds in Bell County, Texas and that any false statement therein may be grounds for which the said Board may refuse to grant e a license to write bail bonds or upon which the Board may suspend or revoke my license to write bail bonds or refuse to renew my license. upon oath and upon the pains and penalties of perjury do hereby swear that the forgoing is a true, complete and accurate financial statement f myself, submitted by me to the Bell County, Texas Bail Bond Board on this the day of, 20. TATE OF TEXAS OUNTY OF BELL SUBSCRIBED AND SWORN TO BEFORE ME, BY, on this the day of, 20, to certify which witness my hand and official seal. Notary Public, State of Texas Typed/Printed name: Commission expires:

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